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Improved Clinical and Radiologic Outcomes Seen after Superior Capsule Reconstruction using Long Head Biceps Tendon Autograft.
Arthroscopy 2021 April 21
PURPOSE: The objective of this study was to investigate the clinical and radiologic outcomes after superior capsule reconstruction (SCR) with biceps tendon (BT) for irreparable rotator cuff tears.
METHODS: The retrospective study period was May 2015 through February 2018. The average follow-up was 32 months (24 to 48 months) after surgery. Study inclusion criteria included an arthroscopic SCR performed using only our technique and minimum 2-year clinical follow-up by office visit and survey. Exclusion criteria included irreparable subscapularis tear and those patients lost to follow-up. This method enabled SCR by using the extraarticular portion and the intraarticular portion and making it 2-3 bundles by moving back and forth in the intraarticular area. Physical examination and functional scoring procedures were performed before surgery; at 3, 6, 12 and 24 months after surgery. Radiography, and magnetic resonance imaging (MRI) were performed before surgery; postoperatively (only radiography); 6 and 24 months after surgery.
RESULTS: 53 shoulders involving 45 consecutive patients underwent BT technique for irreparable massive rotator cuff tears. The VAS, ASES, and Constant score showed statistically significant improvement (VAS, 4.1-1.0; ASES, 60.9-82.7; and CS, 64.9-80.0, P < 0.0001). The shoulder active range of motion improved significantly by 23 for forward elevation (125.3-148.4, P < .0001) and by 12 for external rotation (38.0-50.9, P < .0001). The acromiohumeral distance (AHD) was significantly increased by 2.7 mm (4.4±1.4 mm -> 7.1±1.3 mm). No graft tear was detected in 39 patients (86.7%) during follow-up (24-48 months).
CONCLUSIONS: SCR via our technique improved clinical and radiologic outcomes. 35(77.7%) patients achieved 17-point improvement (the minimally clinically important difference) in the last follow-up of ASES score. Clinical scores and AHD had significantly increased, and good healed rate (86.7%) was observed in MRI.
LEVEL OF EVIDENCE: Level IV, retrospective case series.
METHODS: The retrospective study period was May 2015 through February 2018. The average follow-up was 32 months (24 to 48 months) after surgery. Study inclusion criteria included an arthroscopic SCR performed using only our technique and minimum 2-year clinical follow-up by office visit and survey. Exclusion criteria included irreparable subscapularis tear and those patients lost to follow-up. This method enabled SCR by using the extraarticular portion and the intraarticular portion and making it 2-3 bundles by moving back and forth in the intraarticular area. Physical examination and functional scoring procedures were performed before surgery; at 3, 6, 12 and 24 months after surgery. Radiography, and magnetic resonance imaging (MRI) were performed before surgery; postoperatively (only radiography); 6 and 24 months after surgery.
RESULTS: 53 shoulders involving 45 consecutive patients underwent BT technique for irreparable massive rotator cuff tears. The VAS, ASES, and Constant score showed statistically significant improvement (VAS, 4.1-1.0; ASES, 60.9-82.7; and CS, 64.9-80.0, P < 0.0001). The shoulder active range of motion improved significantly by 23 for forward elevation (125.3-148.4, P < .0001) and by 12 for external rotation (38.0-50.9, P < .0001). The acromiohumeral distance (AHD) was significantly increased by 2.7 mm (4.4±1.4 mm -> 7.1±1.3 mm). No graft tear was detected in 39 patients (86.7%) during follow-up (24-48 months).
CONCLUSIONS: SCR via our technique improved clinical and radiologic outcomes. 35(77.7%) patients achieved 17-point improvement (the minimally clinically important difference) in the last follow-up of ASES score. Clinical scores and AHD had significantly increased, and good healed rate (86.7%) was observed in MRI.
LEVEL OF EVIDENCE: Level IV, retrospective case series.
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